K Number
K971180
Manufacturer
Date Cleared
1997-07-24

(115 days)

Product Code
Regulation Number
876.5860
Reference & Predicate Devices
N/A
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Bard® No-rinse Hemoconcentrator is intended for the relief or mitigation of overhydration in patients undergoing cardiopulmonary procedures and to increase the concentration of cells and proteins in the blood.

Device Description

The Bard No-rinse Hemoconcentrator and accessory kit for hemoconcentration serve the needs of cardiopulmonary procedures. Connected to the external cardiopulmonary blood circuit, the hemoconcentrator generates ultrafiltrate with electrolyte and solute compositions similar to that of plasma water. The Bard' No-rinse Hemoconcentrators are made of glycerin-free polysulphone membranes. The no-rinse feature provides convenience of inserting the device into the external cardiopulmonary blood circuit without the need to rinse the device.

AI/ML Overview

The provided text describes a 510(k) summary for the Bard® No-rinse Hemoconcentrator and Accessory Kit, HC40TS. This type of submission relies on demonstrating substantial equivalence to a predicate device, rather than conducting a full-scale clinical study with acceptance criteria and statistical proof of meeting those criteria in the way an AI/ML device would.

Therefore, many of the requested items (sample size, expert qualifications, adjudication, MRMC studies, standalone performance, ground truth establishment) are not applicable to this type of device submission as they were not part of the required evaluation.

However, I can extract the information relevant to how the device's performance was evaluated for substantial equivalence.

1. Table of Acceptance Criteria and Reported Device Performance

For this 510(k) submission, "acceptance criteria" are implied by the performance of the predicate devices. The new device must perform in a "substantially equivalent" manner. There aren't explicit numerical acceptance criteria stated, but rather a comparison to established devices.

Performance CharacteristicAcceptance Criteria (Implied by Predicate: Fresenius Hemoflow F40)Reported Device Performance (Bard HC40TS)
Cell damageSimilar to predicate devicePerforms in a manner substantially equivalent to predicate devices
Protein analysisSimilar to predicate devicePerforms in a manner substantially equivalent to predicate devices
Sieving coefficientSimilar to predicate devicePerforms in a manner substantially equivalent to predicate devices
Dynamic prime volumeSimilar to predicate devicePerforms in a manner substantially equivalent to predicate devices
Ultrafiltration rateSimilar to predicate devicePerforms in a manner substantially equivalent to predicate devices
Pressure dropSimilar to predicate devicePerforms in a manner substantially equivalent to predicate devices

2. Sample Sizes used for the test set and data provenance

  • Test Set Sample Size: Not explicitly stated as a "test set" in the context of an AI/ML device. Performance testing was conducted to show substantial equivalence to predicate devices. The number of units or tests performed for each characteristic (cell damage, protein analysis, etc.) is not specified.
  • Data Provenance: The document does not specify the country of origin or whether the data was retrospective or prospective. It describes laboratory/bench testing ("performance testing") rather than patient data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. This is a medical device (hemoconcentrator), not an AI/ML diagnostic or prognostic system requiring expert-established ground truth on a test set. Evaluation relies on physical and functional performance testing.

4. Adjudication method for the test set

Not applicable. As above, this is not an AI/ML system requiring expert adjudication.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This is a physical medical device, not an AI system. MRMC studies are not relevant here.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable. This is a physical medical device, not an AI algorithm. Its performance is inherent to its physical characteristics and functionality.

7. The type of ground truth used

For the performance characteristics (cell damage, protein analysis, etc.), the "ground truth" is established through standard laboratory and engineering tests, comparing the new device's performance to the known performance of predicate devices according to established industry and regulatory standards for such devices. The "truth" is the measured physical and functional properties of the device.

8. The sample size for the training set

Not applicable. This is a physical medical device, not an AI/ML system that requires a training set.

9. How the ground truth for the training set was established

Not applicable. This is a physical medical device.

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Image /page/0/Picture/0 description: The image shows a combination of letters and numbers in a handwritten style. The top line features the text "K971180", while the bottom line reads "p.1/3". The text appears to be written with a thick marker or pen, giving it a bold and clear appearance.

Bard Vascular Systems Division C.R. Bard. Inc. 25 Computer Drive Haverhill, MA 01832 508-373-1000

JUL 2 4 1997

An ISO 9001 Registered Division

Image /page/0/Picture/4 description: The image shows the word "BARD" in a bold, sans-serif font. The letters are all capitalized and connected, giving the word a solid, block-like appearance. The color of the letters is black, contrasting with the white background.

510(k) SUMMARY FOR THE BARD' NO-RINSE HEMOCONCENTRATOR AND ACCESSORY KIT- HC40TS

This 510(k) Summary of Safety and Effectiveness is being submitted in accordance with the requirements of SMDA 1990 and 21CFR §807.92.

Submitter Information: I.

Name:Bard Vascular Systems Division, C.R. Bard Inc.
Address:25 Computer Drive, Haverhill, MA 01832
Contact Person:Sandra L. Perreand
Date Summary Prepared:July 2, 1997

II. Device Name:

Proprietary Name:Bard® No-rinse Hemoconcentrator and Accessory Kit, HC40TS
Common or Usual Name:Hemoconcentrator
Classification Name:High Permeability dialyzer

III. Predicate Device(s):

  • Fresenius Hemoflow F40 Capillary Dialyzer 1)
  • Bard Hemoconcentrator with Tubing Set, HC70TS 2)
  • Research Medical Hemoconcentrator, Biofilter™ 140 3)

IV. Device Description:

The Bard No-rinse Hemoconcentrator and accessory kit for hemoconcentration serve the needs of cardiopulmonary procedures. Connected to the external cardiopulmonary blood circuit, the hemoconcentrator generates ultrafiltrate with electrolyte and solute compositions similar to that of plasma water.

The Bard' No-rinse Hemoconcentrators are made of glycerin-free polysulphone membranes. The no-rinse feature provides convenience of inserting the device into the external cardiopulmonary blood circuit without the need to rinse the device.

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Pre-rinsed Hemoconcentrator:

Unit Length:29.4 cm
Unit Diameter:2.8 cm
Membrane Surface Area:0.7m²
Blood Vol (Approx):42 ml
Hollow Fiber Material:Polysulfone
Potting Material:Polyurethane
Filter Housing:Polycarbonate
Port Caps:Polyethylene
Sterilization:Ethylene Oxide
O-Ring:Silicone
Max Transmembrane Pressure:600 mm Hg
Max Safe Blood Flow Rate:500 ml/min

Accessory Kit

(

IDODLength
Blood Inlet tubing1/4"3/8"36"
Blood Outlet tubing1/4"3/8"36"
Filtrate tubing1/4"3/8"36"
1/4" Male Luer Adapter2 each
Tubing material:Polyvinyl chloride

V. Indications for Use:

The indications for use for the subject device and the three predicate device's are as follows:

Indications
Bard HC40TShemoconcentratorThe Bard No-rinse Hemoconcentrator is intended for the relief or mitigation ofoverhydration in patients undergoing cardiopulmonary procedures and toincrease the concentration of cells and proteins in the blood.
Bard HC70TShemoconcentratorThe Bard HC70TS Hemoconcentrator with Tubing Set is intended for use asan ultrafiltration system to remove excess fluid during and/or followingcardiopulmonary bypass procedures where acute hemodilution has beenemployed.
Research MedicalBiofilter 140hemoconcentratorThe RMI BioFilter Hemoconcentrator is intended for use as an ultrafiltrationdevice for the relief or mitigation of overhydration in patients undergoingcardiopulmonary bypass procedures and to decrease the concentration ofplasma water in blood.
Fresenius HemoflowF40 hemodialyzerHemoflow dialyzer Series F (High-Flux) are designed for single use in acuteand chronic haemodialysis.

While the Fresenius dialyzer is indicated for use during kidney dialysis and the Bard hemoconcentrator is indicated for use during cardiopulmonary bypass procedures both device function in the same manner. Both devices are intended to remove excessive fluid and solutes

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from the patients blood. The only difference between the two uses is the procedure in which it's incorporated into, ie; dialysis vs. bypass procedures.

VI. Technological Characteristics:

The Bard HC40TS is identical in terms of design and materials to the Fresenius Hemoflow F40 hemodialyzer. As summary of the technological characteristics are as follows:

HC40TS Bard HemoconcentratorFresenius Hemoflow F40Hemoconcentrator
HousingPolycarbonatePolycarbonate
Potting CompoundPolyurethanePolyurethane
CapillariesPolysulfonePolysulfone
O-ringSiliconeSilicone
Port CapsPolyethylenePolyethylene
Unit Length29.4 cm29.4 cm
Unit Diameter2.8 cm2.8 cm
Membrane Surface Area0.7 m20.7 m2
Max TMP600 mmHg600 mmHg
Max blood flow500 ml/min300 ml/min
Priming volume42 ml42 ml

VII. Performance testing

To determine the adequacy of the HC40TS as a hemoconcentrator the following performance testing was done: Cell damage, protein analysis, sieving coefficient, dynamic prime volume, ultrafiltration rate, and pressure drop. Results of this testing indicate that the HC40TS performs in a manner that is substantially equivalent to the predicate devices.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract image of an eagle or other bird-like figure with three stylized stripes representing its wings or feathers.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 2 4 1997

Ms. Sandra L. Perreand Regulatory Affairs Program Manager Bard Vascular Systems Division ....... C.R. Bard, Inc. 25 Computer Drive Haverhill, Massachusetts 01832

Re: K971180

Bard® No-Rinse Hemoconcentrator and Accessory Kit - HC40 and HC40TS .. . . Dated: July 2, 1997 Received: July 3, 1997 Regulatory class; III 21 CFR §876.5860/Product code: 78 KDI

Dear Ms. Perreand:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic OS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for question and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours.

William Yu

Lillian Yin, Ph.D. Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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ATTACHMENT B

INDICATION STATEMENT

Device Name:

Bard" No-rinse Hemoconcentrator and Accessory Kit- HC40 and . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HC40TS

Indication for Use: The Bard® No-rinse Hemoconcentrator is intended for the relief or mitigation of overhydration in patients undergoing cardiopulmonary procedures and to increase the concentration of cells and proteins in the blood.

Robert P. Setting/
(Division Sign-Off)

Division of Reproductive, Abdominal, ENT, and Radiological Devices 471180 510(k) Number_________________________________________________________________________________________________________________________________________________________________

Prescription Use
(Per 21 CFR 801.109)

Over-the-Counter Use_

§ 876.5860 High permeability hemodialysis system.

(a)
Identification. A high permeability hemodialysis system is a device intended for use as an artificial kidney system for the treatment of patients with renal failure, fluid overload, or toxemic conditions by performing such therapies as hemodialysis, hemofiltration, hemoconcentration, and hemodiafiltration. Using a hemodialyzer with a semipermeable membrane that is more permeable to water than the semipermeable membrane of the conventional hemodialysis system (§ 876.5820), the high permeability hemodialysis system removes toxins or excess fluid from the patient's blood using the principles of convection (via a high ultrafiltration rate) and/or diffusion (via a concentration gradient in dialysate). During treatment, blood is circulated from the patient through the hemodialyzer's blood compartment, while the dialysate solution flows countercurrent through the dialysate compartment. In this process, toxins and/or fluid are transferred across the membrane from the blood to the dialysate compartment. The hemodialysis delivery machine controls and monitors the parameters related to this processing, including the rate at which blood and dialysate are pumped through the system, and the rate at which fluid is removed from the patient. The high permeability hemodialysis system consists of the following devices:(1) The hemodialyzer consists of a semipermeable membrane with an in vitro ultrafiltration coefficient (K
uf ) greater than 8 milliliters per hour per conventional millimeter of mercury, as measured with bovine or expired human blood, and is used with either an automated ultrafiltration controller or anther method of ultrafiltration control to prevent fluid imbalance.(2) The hemodialysis delivery machine is similar to the extracorporeal blood system and dialysate delivery system of the hemodialysis system and accessories (§ 876.5820), with the addition of an ultrafiltration controller and mechanisms that monitor and/or control such parameters as fluid balance, dialysate composition, and patient treatment parameters (e.g., blood pressure, hematocrit, urea, etc.).
(3) The high permeability hemodialysis system accessories include, but are not limited to, tubing lines and various treatment related monitors (e.g., dialysate pH, blood pressure, hematocrit, and blood recirculation monitors).
(b)
Classification. Class II. The special controls for this device are FDA's:(1) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Device—Part I: Evaluation and Testing,’ ”
(2) “Guidance for the Content of 510(k)s for Conventional and High Permeability Hemodialyzers,”
(3) “Guidance for Industry and CDRH Reviewers on the Content of Premarket Notifications for Hemodialysis Delivery Systems,”
(4) “Guidance for the Content of Premarket Notifications for Water Purification Components and Systems for Hemodialysis,” and
(5) “Guidance for Hemodialyzer Reuse Labeling.”